This topic is about dealing with recurring skin irritation and damage around the stoma, which might be influenced by a parastomal hernia. The person experiencing this issue has been using a specific routine to manage the skin breakdown, but the problem keeps coming back. They are also considering whether the hernia or the hernia belt might be contributing to the skin issues.

Here are some helpful insights and advice:

1. Seek professional advice from a dermatologist or a WOC (ostomy) nurse, especially for open wounds and recurring skin ulcers.

2. Avoid applying stoma paste directly on broken or irritated skin. Instead:
- Clean the area and let it air-dry. Taking a bagless shower can help with this.
- Use the "crusting" method by dusting Nystatin powder (for fungal or weeping skin) or another stoma adhesive powder, then sealing it with a skin-prep spray before applying the wafer.

3. Consider using protective skin products:
- Skin barrier sheets, which are thin hydrocolloid sheets, can be cut to size and placed over the sore area before applying the wafer. They are gentler than adhesive extenders.

4. Check the stoma protrusion and the fit of the appliance. Persistent leaks or pressure points can cause repeated skin damage. Make sure the choice between a convex or flat wafer matches the stoma profile.

5. For stubborn peristomal irritation, try using Salts Healthcare Aloe-infused Barrier Rings. These rings can soothe raw skin and improve wear time. Free samples are available from Salts.

6. If the hernia belt is causing friction, try alternating belts or adding a thin layer of soft gauze under the belt at the problem spot to reduce rubbing.

7. Once the skin heals, gradually extend the wear-time of the appliance, aiming for 5–7 days, as long as the wafer seals well and the skin remains dry.